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THE PAPE GROUP, INC. (( � <br /> vV <br /> REQUIRED SAFETY TRAINING FOR NEW MEMBERS <br /> Member Name: Q Hire/Transfer Date: <br /> Job Title: S Company/Location: <br /> The member must be trained(or scheduled to be <br /> trained) in the following topics prior to beginning work. <br /> Documentation of the training is required. ` <br /> A <br /> Note: Do not take your training and documentation w Q F <br /> responsibility lightly. Documenting that training and/or <br /> instruction has taken place can actually increase the ~ °' <br /> Completion <br /> company's liability if such training is inadequate for the Q `" `n v Date <br /> job. py c <br /> • Introduction to members and tour of facility X X X X X <br /> • <br /> Safety Attitude—Review Safety Policy 4 5.01 X X X X X <br /> • Review General Safety Provisions(IIPP)/074AB14 <br /> • Housekeeping X X X X X <br /> Clear aisle ways <br /> Clear exits <br /> Clean up of spills <br /> Responsibility for your area <br /> • Violence Response Policy X X X X X <br /> • Review Job Specific Job Hazard Analysis/074AB15 <br /> • First Aid—location of kit, stretcher,blanket,eyewash, X X X X X <br /> and deluge showers. First aid trained personnel. <br /> • Emergency Action Plan—911 X X X X X <br /> Poster with store address <br /> Ambulance and Hospital Phone numbers <br /> Map of Store and exits,Meeting lace <br /> • How to report on the job accidents, incidents, and near X X X X X <br /> accidents <br /> • Have Member attend the first safety meeting held after X X X X X <br /> date of employment <br /> 1 acknowledge I have received the above training,that I do d wh did not understand,and that I agree to <br /> abide by prescribed work practices and rule beh ' r <br /> Member Signer Date: <br /> This member has been trained in the ve areas and I am confident in his or her knowledge of and competency in <br /> the areas requiring dftonstrati of s w r p ctices. <br /> Manager Signature: Date: <br />